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Gebelikte Frontal QRS-T Açısının Değerlendirilmesi

Year 2022, Volume: 24 Issue: 3, 454 - 459, 31.12.2022
https://doi.org/10.24938/kutfd.1093625

Abstract

Amaç: Bu çalışmadaki amacımız gebe kadınlarda repolarizasyon defekti ve aritmojenik yatkınlığın önemli bir göstergesi olan frontal QRS–T (fQRS-T) açısındaki değişikliklerin gebe olmayan kadınlara ve trimester gruplarına göre değerlendirmektir.
Gereç ve yöntemler: Çalışmaya kardiyak veya kronik hastalık öyküsü olmayan 157 gebe ve kontrol grubu olarak 150 sağlıklı gebe olmayan kadın dahil edildi. PR, QRS, QT, düzeltilmiş QT ve fQRS-T açıları manuel olarak hesaplandı. Her üç trimesterin EKG verilerine erişilebilen 58 gebe kadının EKG'sinde trimester değişikliklerinin etkilerini araştırmak için alt grup analizi yapıldı.
Bulgular: Çalışmaya katılanların yaş ortalaması 31±7 yıl idi. Gebelerin ve kontrol grubunun kalp atım hızları sırasıyla 83±12 bpm ve 76±14 bpm (p<0.001) iken, fQRS–T açıları sırasıyla 27.6°±17.7° ve 20.7°±6.6° olarak ölçüldü (p<0.001). Frontal QRS-T açısında da birinci trimesterden (34.4±15.4) ikinci (26.5±14.8) ve üçüncü (23.3±20.3) trimesterlere (p = 0.003) ilerlemede anlamlı azalma saptandı. Gebelik haftası fQRS-T açısı ile istatistiksel olarak anlamlı negatif korelasyon gösterdi (r = -0.233; p = 0.003).
Sonuç: fQRS-T açısı, normal aralıkta kalsa bile, gebe kadınlarda gebe olmayanlara göre ve aynı zamanda birinci trimester gebe kadınlarda ikinci veya üçüncü trimestere göre daha büyüktü.

References

  • Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014;130(12):1003-8.
  • Simmons LA, Gillin AG, Jeremy RW. Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy. Am J Physiol Heart Circ Physiol. 2002;283(4):H1627-33.
  • Cordina R, McGuire MA. Maternal cardiac arrhythmias during pregnancy and lactation. Obstet Med. 2010;3(1):8-16.
  • Briller J, Koch AR, Geller SE. Illinois Department of Public Health Maternal Mortality Review Committee Working Group. Maternal Cardiovascular Mortality in Illinois, 2002-2011. Obstet Gynecol. 2017;129(5):819-26.
  • Oehler A, Feldman T, Henrikson CA, Tereshchenko LG. QRS-T angle: a review. Ann Noninvasive Electrocardiol. 2014;19(6):534-42.
  • Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849-56.
  • Grindheim G, Estensen ME, Langesaeter E, Rosseland LA, Toska K. Changes in blood pressure during healthy pregnancy: a longitudinal cohort study. J Hypertens. 2012;30(2):342-50.
  • Robson SC, Hunter S, Moore M, Dunlop W. Hemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol. 1987;94(11):1028-39.
  • Umar S, Nadadur R, Iorga A, Amjedi M, Matori H, Eghbali M. Cardiac structural and hemodynamic changes associated with physiological heart hypertrophy of pregnancy are reversed postpartum. J Appl Physiol. 2012;113(8):1253-9.
  • Campos O, Andrade JL, Bocanegra J, Ambrose JA, Carvalho AC, Harada K et al. Physiologic multivalvular regurgitation during pregnancy: a longitudinal Doppler echocardiographic study. Int J Cardiol. 1993;40(3):265-72.
  • Kurisu S, Nitta K, Watanabe N, Ikenaga H, Ishibashi K, Fukuda Y et al. Associations of frontal QRS-T angle with left ventricular volume and function derived from ECG-gated SPECT in patients with advanced chronic kidney disease. Annals of Nuclear Medicine. 2021;35(6): 662-8.

EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY

Year 2022, Volume: 24 Issue: 3, 454 - 459, 31.12.2022
https://doi.org/10.24938/kutfd.1093625

Abstract

Objective: Our aim in this study was to evaluate changes in the frontal QRS–T (fQRS-T) angle, which is an important indicator of repolarisation defects and arrhythmogenic predisposition, in pregnant women relative to non-pregnant women and between trimester groups.
Material and Methods: One hundred fifty-seven pregnant women with no history of cardiac or chronic disease and 150 healthy non-pregnant women as a control group were included in this study. PR, QRS, QT, corrected QT and fQRS-T angles were calculated manually. Subgroup analysis was performed to investigate the effects of changes in trimester on ECG of 58 pregnant women, whose ECG data of all three trimesters could be accessed.
Result: The mean age of study participants was 31±7 years. The heart rates of pregnant women and the control group were 83±12 bpm and 76±14 bpm respectively (p<0.001), while fQRS–T angles measured 27.6°±17.7° and 20.7°±6.6° respectively (p<0.001). The frontal QRS-T angle was also detected significantly decrease in the progression from the first trimester (34.4±15.4) to the second (26.5±14.8) and third (23.3±20.3) trimesters (p=0.003). Gestational week had a statistically significant negative correlation with fQRS-T angle (r = −0.233; p=0.003).
Conclusion: The fQRS-T angle, even if remained within the normal range was larger in pregnant women than in non-pregnant women and also larger in first trimester pregnant women relative to those in the second or third trimester.

References

  • Sanghavi M, Rutherford JD. Cardiovascular physiology of pregnancy. Circulation. 2014;130(12):1003-8.
  • Simmons LA, Gillin AG, Jeremy RW. Structural and functional changes in left ventricle during normotensive and preeclamptic pregnancy. Am J Physiol Heart Circ Physiol. 2002;283(4):H1627-33.
  • Cordina R, McGuire MA. Maternal cardiac arrhythmias during pregnancy and lactation. Obstet Med. 2010;3(1):8-16.
  • Briller J, Koch AR, Geller SE. Illinois Department of Public Health Maternal Mortality Review Committee Working Group. Maternal Cardiovascular Mortality in Illinois, 2002-2011. Obstet Gynecol. 2017;129(5):819-26.
  • Oehler A, Feldman T, Henrikson CA, Tereshchenko LG. QRS-T angle: a review. Ann Noninvasive Electrocardiol. 2014;19(6):534-42.
  • Mahendru AA, Everett TR, Wilkinson IB, Lees CC, McEniery CM. A longitudinal study of maternal cardiovascular function from preconception to the postpartum period. J Hypertens. 2014;32(4):849-56.
  • Grindheim G, Estensen ME, Langesaeter E, Rosseland LA, Toska K. Changes in blood pressure during healthy pregnancy: a longitudinal cohort study. J Hypertens. 2012;30(2):342-50.
  • Robson SC, Hunter S, Moore M, Dunlop W. Hemodynamic changes during the puerperium: a Doppler and M-mode echocardiographic study. Br J Obstet Gynaecol. 1987;94(11):1028-39.
  • Umar S, Nadadur R, Iorga A, Amjedi M, Matori H, Eghbali M. Cardiac structural and hemodynamic changes associated with physiological heart hypertrophy of pregnancy are reversed postpartum. J Appl Physiol. 2012;113(8):1253-9.
  • Campos O, Andrade JL, Bocanegra J, Ambrose JA, Carvalho AC, Harada K et al. Physiologic multivalvular regurgitation during pregnancy: a longitudinal Doppler echocardiographic study. Int J Cardiol. 1993;40(3):265-72.
  • Kurisu S, Nitta K, Watanabe N, Ikenaga H, Ishibashi K, Fukuda Y et al. Associations of frontal QRS-T angle with left ventricular volume and function derived from ECG-gated SPECT in patients with advanced chronic kidney disease. Annals of Nuclear Medicine. 2021;35(6): 662-8.
There are 11 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Özgün Araştırma
Authors

Emre Yılmaz 0000-0002-1656-3778

Kıymet İclal Ayaydın Yılmaz

Ercan Aydın 0000-0001-8743-3762

Publication Date December 31, 2022
Submission Date March 26, 2022
Published in Issue Year 2022 Volume: 24 Issue: 3

Cite

APA Yılmaz, E., Ayaydın Yılmaz, K. İ., & Aydın, E. (2022). EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY. The Journal of Kırıkkale University Faculty of Medicine, 24(3), 454-459. https://doi.org/10.24938/kutfd.1093625
AMA Yılmaz E, Ayaydın Yılmaz Kİ, Aydın E. EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY. Kırıkkale Uni Med J. December 2022;24(3):454-459. doi:10.24938/kutfd.1093625
Chicago Yılmaz, Emre, Kıymet İclal Ayaydın Yılmaz, and Ercan Aydın. “EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY”. The Journal of Kırıkkale University Faculty of Medicine 24, no. 3 (December 2022): 454-59. https://doi.org/10.24938/kutfd.1093625.
EndNote Yılmaz E, Ayaydın Yılmaz Kİ, Aydın E (December 1, 2022) EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY. The Journal of Kırıkkale University Faculty of Medicine 24 3 454–459.
IEEE E. Yılmaz, K. İ. Ayaydın Yılmaz, and E. Aydın, “EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY”, Kırıkkale Uni Med J, vol. 24, no. 3, pp. 454–459, 2022, doi: 10.24938/kutfd.1093625.
ISNAD Yılmaz, Emre et al. “EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY”. The Journal of Kırıkkale University Faculty of Medicine 24/3 (December 2022), 454-459. https://doi.org/10.24938/kutfd.1093625.
JAMA Yılmaz E, Ayaydın Yılmaz Kİ, Aydın E. EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY. Kırıkkale Uni Med J. 2022;24:454–459.
MLA Yılmaz, Emre et al. “EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY”. The Journal of Kırıkkale University Faculty of Medicine, vol. 24, no. 3, 2022, pp. 454-9, doi:10.24938/kutfd.1093625.
Vancouver Yılmaz E, Ayaydın Yılmaz Kİ, Aydın E. EVALUATION OF THE FRONTAL-PLANE QRS-T ANGLE IN PREGNANCY. Kırıkkale Uni Med J. 2022;24(3):454-9.

This Journal is a Publication of Kırıkkale University Faculty of Medicine.